Search This Blog

Saturday, January 1, 2022

Massive sewage spill closes beaches around LA

 Beaches were closed in the Los Angeles area this weekend following a historic spill of up to 7 million gallons of untreated sewage.

A 48-inch sewer main line failed on Thursday, sending millions of gallons into the Dominguez Channel, which flows into the Los Angeles harbor, the city of Long Beach said in a Friday press release.

After the spill, Los Angeles County ordered the closure of multiple beaches, ABC 7 reported. The city of Long Beach temporarily closed seven miles of its beaches and Orange County closed off Seal Beach.

Sewage even made its way into city streets after the spill.

Reporter Jessica De Nova wrote on Twitter that one neighborhood was "filled w/awful odors & this river of raw sewage running through their street Thursday," adding that residents "hope their government leaders do more to improve quality of life here."

Los Angeles County Supervisor Janice Hahn called for an investigation into the pipelines and sewer infrastructure to determine whether it was faulty.

"A spill of this magnitude is dangerous and unacceptable, and we need to understand what happened," said in a statement.

https://thehill.com/policy/energy-environment/587884-massive-sewage-spill-closes-beaches-around-los-angeles

Biden goal of 500M free tests will require major production scale-up, months

 Meeting President Joe Biden’s goal of offering 500 million free at-home Covid-19 tests for Americans will require a massive scale-up in test manufacturing that may take months to achieve — falling short of demand as the omicron variant drives a surge in infections.

The U.S. had a supply of around 200 million at-home rapid tests in December. Test-makers have indicated they will be able to increase that to just over 500 million a month by March with added capacity from current manufacturers and the recent clearance of two new tests from Roche and Siemens, according to estimates from Mara Aspinall, a health professor at Arizona State University who tracks the testing market.

Not all of those tests will go to the federal government’s free testing effort. A White House official said the 500 million free at-home tests will come from additional supply the administration is anticipating will be added.

But even with new tests being approved and manufacturers racing to expand capacity, the number of new tests available is expected to grow just modestly in January while Roche and Siemens begin packaging and shipping their products, ramping up more significantly in February. That means it could take several months for the federal government to meet its goal, according to production targets from the manufacturers and Aspinall’s estimates.

"I am much more confident than I was a week ago that we can meet the need," Aspinall said. "The challenge is how quickly we can get those tests shipped out and how quickly we can meet that 500 million goal."

Administration officials haven’t said when they expect to have all 500 million tests available for the public, beyond saying the first batch of tests will start going out sometime in January. Officials with the Defense Department and Department of Health and Human Services are aiming to finalize contracts with test manufacturing companies late next week and are working on an “accelerated contracting timeline,” White House Covid response coordinator Jeffrey Zients said Wednesday. Officials are also still working on the website where people will be able to request a test and a system for distributing them, he said.

It also remains unclear how the tests will be distributed, which agency will be tasked with that process and how many tests each person will be able to get.

“There are a lot of unanswered questions,” Aspinall said. “It’s the combination of understanding the supplying pathways, then on top of that figuring out what the supply chain looks like, what the distribution looks like and how the whole process comes together.”

Biden has made testing a priority for this administration in recent months, committing to spend $3 billion in the fall on at-home tests to spur companies to scale up production as the government distributes millions of at-home tests to food banks and health clinics. Administration officials have urged Americans to get tested before holiday gatherings as an added layer of protection and enforced testing programs in schools to keep children in the classroom.

Even before Biden announced his plan for the federal government to buy 500 million tests, representatives for test manufacturers had been pushing to ramp up production further, hiring more workers, adding shifts and tapping subcontractors to help, with production going from 80 million tests in November to just over 200 million in December.

Abbott, maker of BinaxNow, said it plans to increase capacity to 70 million tests per month from 50 million, and Quidel is increasing its production of the QuickVue test to the same amount. Access Bio said it was targeting 25 million tests for December and planned to produce an additional 40 million in the coming months. Ellume said it will start making 15 million more tests a month after production launches at its new facility in Frederick, Maryland, in January.

The Food and Drug Administration also gave clearance in the last week to new tests from Roche and Siemens, with each company saying the plan is to have “tens of millions” of the new tests available each month, without offering a specific timeline for how many tests would be delivered when.

Having the federal government ready to purchase such a large amount of tests could give the test-makers an incentive to ramp up production even further than planned, though demand from consumers and local governments for the tests has already outstripped the available supply, Aspinall said.

While the federal push is helping bolster the market for manufacturers, it has also raised questions about what effect it could have on the wider availability of tests. Arkansas Gov. Asa Hutchinson told Biden earlier this week on a call that he was worried his state won’t have enough of the rapid tests for its test-to-stay program for schools, where students exposed to an infected classmate are able to remain in class if they test negative.

The Association of State and Territorial Health Officials raised a similar concern to Biden administration officials, questioning whether the federal government's massive purchasing of tests might cut into their ability to access tests for their own programs. Michael Fraser, the group's CEO, said administration officials assured him that the federal government's efforts won't hinder states' plans.

Also competing for tests will be employers and their workers, if Biden’s vaccine mandate survives legal challenges. Under that rule, unvaccinated employees would have to show proof of a negative Covid test every week.

Hutchinson warned Biden that the administration should not "let federal solutions stand in the way of state solutions."

"The production of 500 million rapid tests that will be distributed by the federal government is great," the Arkansas Republican said, "but obviously that dries up the supply chain for the solutions that we might offer as governors.”

https://www.nbcnews.com/politics/white-house/biden-s-goal-500-million-free-tests-will-require-major-n1286768

Taiwan rejects US CDC guidance on 5-day quarantine

 The Central Epidemic Command Center (CECC) on Thursday (Dec. 30) announced that it will not follow U.S. Centers for Disease Control and Prevention (CDC) guidance on shortened quarantines because some imported Omicron cases have been found to be infectious up to 12 days after testing positive.

On Monday (Dec. 27), the U.S. CDC shortened the recommended period that asymptomatic people should undergo quarantine after testing positive from 10 days to five, as long as they wear a mask for another five. It also shortened the isolation period for vaccinated people who have been exposed to the virus to five days.

During a press conference on Dec. 30, Philip Lo (羅一鈞), deputy head of the CECC’s medical response division, announced that a total of 59 imported Omicron cases have been detected in Taiwan. Of these cases, 55 were breakthrough infections, three had received one dose of a vaccine, and one had not been vaccinated.

More than 80% of these cases were detected upon arrival in Taiwan, while the rest tested positive within six days after entering the country.

CECC head Chen Shih-chung (陳時中) said that at present, it appears the incubation period of the Omicron variant is relatively short. Therefore, he stressed that the first seven days after entry are a very important line of defense.

He warned that if a cluster infection appears in a quarantine center or epidemic prevention hotel and is not detected in time, it could quickly spread into the community. If community transmission occurred, it would be a daunting task to contain, and the risk to society would increase substantially, Chen said.

study by the New England Journal of Medicine released on Dec. 23 found vaccine recipients infected with COVID "may clear the infection more quickly than unvaccinated persons." When asked to comment on this study, Lo explained that the research had been carried out on subjects infected with the Alpha and Delta variants and that vaccine efficacy with the Omicron strain remains to be seen.

Regarding the U.S. CDC's recommendation to shorten quarantines from 10 to five days, Lo said 23 imported Omicron cases have been tracked for more than five days. He pointed out that of these cases, 17 had a Ct level of 30 or higher, meeting the standard to be released from quarantine.

Lo added that these cases did not reach this Ct level until at least eight days after they had fallen ill or tested positive. He said the longest it has taken for an Omicron case to reach the standard for release is 12 days after diagnosis.

Lo stated that after discussions with a panel of experts from the Ministry of Health and Welfare’s Advisory Committee for Immunization Practices (ACIP), the conclusion was that if quarantine stays were shortened to five days, there may still be a risk of infection and impact on community safety. Therefore, the experts advised that Taiwan not follow the U.S. guidance but continue to maintain the current quarantine regulations.

He explained that the current standard for releasing a COVID case from isolation is either 10 days after the onset of symptoms or a positive test followed by two consecutive tests resulting in a Ct value equal to or greater than 30.

https://www.taiwannews.com.tw/en/news/4393548

Largest NJ Hospital System Sees Admits Exceeding Worst of 2020 Soon

 As COVID-19 hospitalizations rise 10% a day in New Jersey, the state's largest hospital system says it is a (short) matter of time until 2020's grim record is broken.

"If you look at what the (health) commissioner and governor are positing relative to their COVID models, sometime in the middle of January we’re likely to see the same level of hospitalization we were seeing back in March, April of 2020," Dr. Daniel Varga, the chief physician executive of Hackensack Meridian Health, told News 4.

HMH has 17 hospitals statewide and thousands of beds, but as more patients come in -- and more staffers get sick too -- the pressure on the system will rise. Crisis planning is underway at the hospital system, as healthcare providers are now preparing to strike elective surgeries as early as mid-January, according to state modeling that Varga has seen.

"We’re already teeing up our process for how we will manage when we have to go to crisis standards of care, because I just think it's going to get there," Varga said.

It comes as the state hospital association issued a "Level Red," which means that virtually no visitation will be allowed at hospitals, except generally for birthing and pediatric cases — and even then, only one person is allowed at a time. Hospital diverts have also soared in recent days, as one in five emergency rooms were on divert Wednesday night.

As it stands now, there are about 3,600 people in the hospital with COVID in New Jersey, a figure that has doubled in less than two weeks. According to the New Jersey Hospital Association, at the very depths of the pandemic, on April 14, 2020, there were 8,065 people hospitalized with the virus.

Varga said the state's models peak at somewhere between 7,000 and 9,000 admissions in the current wave, and he added those would primarily be unvaccinated people between about ages 20 and 60. The peak was just over 8,000 nearly two years ago, when hospitals were basically treating nothing but COVID — but Varga notes that hospitals now have new ways to fight the worst of the virus.

"We know how to manage patients without ventilators a lot better, we use high-flow oxygen," Varga said.

Earlier Thursday, the state reported nearly 28,000 new cases of COVID-19, up 35% from the day before and more than 300% higher than the pre-omicron record.

https://www.nbcnewyork.com/news/coronavirus/njs-largest-hospital-system-expects-hospitalizations-to-exceed-worst-of-2020-soon/3473230/

Turkey starts offering 5th dose of COVID-19 booster shots

 The Health Ministry started offering the fifth booster doses of COVID-19 vaccines for a specific group of people, the ministry said Friday.

Individuals who received two doses of the Chinese Sinovac and two doses of the BioNTech vaccine at least three months ago will be able to get an appointment for the fifth dose.

They will be able to receive the Sinovac, BioNTech or the domestically-made Turkovac vaccines as a booster.

Turkovac, a domestically developed inactive COVID-19 vaccine, is finally available to the public after receiving emergency use approval. On Thursday, city hospitals became the first venues for inoculation with Turkovac, and the vaccination program with the local jab is expected to expand to all hospitals and other venues within weeks.

Experts also hope that the domestically-developed vaccine will eliminate vaccine hesitancy in the country.

Over 83% of people over the age of 18 have received two doses of a COVID-19 vaccine, while 91.6% received a single dose.

The number of shots administered in the country has reached well in excess of 1.3 million doses according to the ministry.

https://www.dailysabah.com/turkey/turkey-starts-offering-5th-dose-of-covid-19-booster-shots/news

HK to bar unvaccinated from eateries, gyms, cinemas, amid fears of 5th wave, Omicron

 Secretary of Food and Health Sophia Chan announced the new measures at a press conference on Friday, including the expansion of the “vaccine bubble” scheme in high-risk places such as catering premises.

“We are not saying that one dose of vaccination is enough, but we also have to be practical… we want to implement this measure for all the scheduled premises under Cap. 599 as soon as possible,” Chan said.

She added that they understand people would be gathering during the holiday, therefore the government’s plan is to expand the “vaccine bubble” before Lunar New Year. “It is important for them to protect themselves as soon as possible.”

Chan said the move is to “further promote and boost” vaccination among older age groups who are more vulnerable to severe symptoms: “Especially those who are over 80 years [old], [the vaccination rate] is only 20 per cent, which is very low.”

The city confirmed its first two local cases of the Omicron variant on Friday, as two people tested positive after dining in the same restaurant with a Cathay Pacific aircrew member confirmed to have the infection.

Director of the Department of Health Ronald Lam said during a Friday press conference that Hong Kong “could be at the tipping point of the fifth-wave of the outbreak.”

The Hospital Authority announced that the temporary field hospital at Asia World Expo will reopen on Sunday and provide 500 beds to stable Covid-19 patients.

The quarantine requirements for cargo aircrew members will also be tightened, as they will be required to undergo seven days – instead of three days – of hotel quarantine starting from Saturday.

Officials urged the public to cooperate with compulsory testing, get vaccinated, minimise unnecessary travel and avoid crowded places or mask-off gatherings.

However, the authority did not call off celebration events for the 2022 countdown, including the Hong Kong New Year Countdown Concert organised by the Hong Kong Tourism Board in the West Kowloon Cultural District on Friday.

When asked about the concert, Chan said the organisers of the event must strictly follow requirements on testing, vaccination and use of the “LeaveHomeSafe” app before allowing entry.

She added that citizens should try their best to avoid crowded venues and gatherings without masks.

As of Thursday, the total number of confirmed Covid-19 cases in Hong Kong is 12,649, while the death toll stands at 213.

https://hongkongfp.com/2021/12/31/covid-19-hong-kong-to-bar-unvaccinated-from-eateries-gyms-cinemas-amid-fears-over-fifth-wave-and-omicron/

Retooling CAR T cells to serve as ‘micropharmacies’ for cancer drugs

 Immunotherapies called chimeric antigen receptor (CAR) T cells use genetically engineered versions of a patient’s own immune cells to fight cancer. These treatments have energized cancer care, especially for people with certain types of blood cancers. Now, scientists at Memorial Sloan Kettering Cancer Center’s Sloan Kettering Institute (SKI) have developed new CAR T cells that can do something their predecessors cannot: Make drugs.

Standard-issue CAR T cells are designed in the lab to recognize specific markers on cancer cells. When these CAR T cells are given back to a patient, they proliferate and go on the attack, acting as a kind of “living drug.”

Despite their usefulness for treating blood cancers, there are several limitations of current CAR T models. One is that the CAR T cells can only kill cancer cells that contain the marker they are designed to recognize. But it is not uncommon for cancer cells to stop making this marker and thus to “escape” from the therapy.

A second problem is that CAR T cells can become “exhausted” — and even inhibited by the cancer cells themselves. Lastly, existing CAR T cells work well only against blood cancers that the CAR T cells can easily reach. Against dense solid tumors in the lung or breast, they are mostly powerless. 

To overcome these hurdles, a team of SKI researchers has designed an entirely new type of CAR T cell that acts as a “micropharmacy”: It can deliver a toxic drug payload directly to a tumor, killing both tumor cells that contain the cancer marker as well as those cancer cells nearby that do not. What’s more, the engineered cells can produce the drug even after they become exhausted, and the drug is not suppressed by the cancer.

“We call them SEAKER cells,” says physician-scientist David A. Scheinberg, Chair of the Molecular Pharmacology Program in SKI who also directs the Center for Experimental Therapeutics. “SEAKER stands for Synthetic Enzyme-Armed KillER cells. These cells combine the target-seeking power of immune cells with the ability to locally generate a potent anticancer drug for double effect.”

The cancer-fighting molecule is one that SKI Chemical Biology Program Chair Derek Tan — Dr. Scheinberg’s collaborator on the project — discovered previously while developing antibiotics. The molecule, called AMS, is so powerful that it cannot be injected directly into an animal’s bloodstream. But when it is produced locally just at the site of a tumor, it is effective at safely killing cancer cells in mice. The scientists have not yet tested the technology in people.

Details about the SEAKER platform, which the scientists say has applicability to both cancer and other diseases, were published on December 30, 2021, in Nature Chemical Biology.

A Unique Drug-Delivery Approach

The idea of using CAR T cells to deliver additional therapeutic agents isn’t brand new. Several research groups have shown it’s possible to get them to make immune proteins like antibodies and cytokines. But getting CAR T cells to produce a small-molecule cancer drug is a trickier prospect.

“Human cells cannot normally make this type of compound,” Dr. Tan says.

To find a work-around, the team devised a clever approach. They linked the cancer drug to another chemical that “masks” its function. Then, they genetically engineered the T cells to make an enzyme that cuts the masking molecule from the drug.

“In contrast to small-molecule drugs, human cells are very good at making enzymes, so CAR T cells are able to produce it effectively,” Dr. Tan adds.

When the inactive version of the drug, called a prodrug, is injected into the bloodstream, it circulates through the body. The enzyme produced by the CAR T cells acts like a scissor, releasing the active part of the prodrug at the site of the tumor.

The scientists tested their SEAKER cells on both cancer cells growing in a dish and in mouse models. In both cases, the SEAKER cells performed better than regular CAR T cells at killing the cancer cells.

The SKI team also showed that their SEAKER cells work with several different prodrugs and several different cleaving enzymes — hence their referring to this technology as a “platform.”

A Risky Bet That Paid Off

The scientists emphasize the “high risk, high reward” nature of their research.

“It’s one of the wildest ideas I’ve ever worked on,” Dr. Tan says. “It’s very exciting that we got it to work.”

Thanks to seed funding from MSK’s Center for Experimental Therapeutics and philanthropy, they were able to take a risk and eventually get the idea off the ground. Later, the National Institutes of Health (NIH) provided additional funding.

Dr. Tan adds that this project is a good example of how the pursuit of noncancer-related basic science at MSK can spawn new discoveries with relevance to cancer.

SEAKING Out Cancer and Other Diseases

Now that the scientists have shown that their SEAKER cells work in mice, there has been a lot of interest in the approach. In fact, a company called CoImmune has already licensed the technology from MSK to develop the CAR T cell technology for human trials.

“There is an opportunity to better understand the limitations of CAR T cells and specifically engineer new treatment options that have the potential to address challenges with eliminating tumor masses and toxicity,” says Charles Nicolette, PhD, chief executive officer of CoImmune. “This exciting collaboration positions us to evaluate this completely novel approach that may provide a new treatment option for patients with solid tumors.”

“The collaboration with CoImmune is exciting because we need a company to take this on to scale up and manufacture a standardized product,” Dr. Scheinberg adds.

Another part of the appeal of the SEAKER technology is that it has more than one possible application.

“You could imagine it being used to produce drugs to fight other conditions, such as autoimmune diseases and infections,” Dr. Scheinberg says.

But for now, the focus of the MSK researchers and CoImmune will be on cancer. Dr. Scheinberg speculates that a clinical trial in cancer is about two to three years away.